Is Radiofrequency Denervation Effective for Chronic Low Back Pain?
According to a new study published in JAMA, radiofrequency denervation was not associated with clinical improvement in chronic low back pain in patients who were unresponsive to conservative care.
Researchers from Holland sought to evaluate the effectiveness of radiofrequency denervation – the application of an electric current to a pain-conducting nerve – as the treatment is commonly used but isn't backed by high-quality evidence of efficacy.
The trial was non-blinded, lasted for 3 months, and took place at 16 pain clinics in Holland. A total of 681 patients took part, all had chronic low back pain originating in potential sources of the spinal column: the facet joints, sacroiliac joints, or a combination of facet joints, sacroiliac joints, or intervertebral disks. All participants took part in a standardized exercise program while the intervention group was administered radiofrequency denervation, at most three times during the trial. Pain intensity, measured 3 months after the intervention using a numeric rating scale, was the primary outcome.
Results showed a statistically significantly, but not a clinically important, improvement in two of the trials which evaluated radiofrequency denervation for the sacroiliac joints (−0.71 (95% CI, −1.35 to −0.06) and a combination of the facet joints, sacroiliac joints or intervertebral disks (−0.99 (95% CI, −1.73 to −0.25) at 3 months.
The researchers acknowledged that the non-blinded nature of the study presented a limitation, even so, they concluded, “The findings [of the study] do not support the use of radiofrequency denervation to treat chronic low back pain from these [facet, sacroiliac, a combination of both joints, or intervertebral disks] sources.”
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